对超重和肥胖孕妇的生活方式干预:一项系统综述。

Women's health (London, England) Pub Date : 2025-01-01 Epub Date: 2025-05-19 DOI:10.1177/17455057251336292
Tahlie Park, Scarlett Brickwood, Kelsey Buss, Vivian Tran, David Parsons, Kerrie Wisely, Katharine Gillett, Heidi Lavis, Susan Heaney
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引用次数: 0

摘要

背景:妊娠期体重增加(GWG)影响胎儿和孕产妇的健康结局,超重和肥胖人群的GWG过高进一步增加了这一人群并发症的风险。改变生活方式,包括健康饮食和体育活动是管理的核心策略。自2020年和2019冠状病毒病大流行出现以来,远程医疗的使用有所增加;然而,人们对虚拟分娩策略在怀孕期间保持健康妊娠体重的有效性知之甚少。目的:描述虚拟交付的生活方式干预对促进健康GWG和减少与GWG过多相关的母婴并发症的影响,以期为未来的临床实践提供信息。设计:本系统综述遵循系统综述和荟萃分析(PRISMA)指南的首选报告项目和有针对性的定量研究,评估虚拟提供的生活方式干预措施,以维持18岁及以上超重和肥胖孕妇的健康妊娠体重。数据来源和方法:采用严格的检索策略检索MEDLINE、CINHAL、EMBASE、EMCARE、MIDIRS和APA PsycINFO 6个数据库。数据提取调查了远程医疗服务模式、干预类型和GWG结果。使用关键评估技能计划工具进行质量评估,使用风险偏倚评估(rob2)评估偏倚风险。结果:9项研究符合纳入标准,在这些研究中确定了6种不同的远程保健模式。干预措施多种多样,包括GWG跟踪、步数、饮食和锻炼目标设定。研究的有效性不一致,有五项研究显示GWG较低。结论:结果表明,通过远程医疗提供的生活方式干预可能有效减少过量的GWG。应将制定目标明确的干预措施纳入产科准则,旨在通过远程保健平台减少过度的全球孕妇死亡率,这不仅是应对大流行病的战略,也是增加产前保健和提供服务的战略。注册:普洛斯彼罗国际前瞻性注册于2023年1月26日(CRD42023392095)。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Virtually delivered lifestyle interventions for overweight and obese pregnant people: A systematic review.

Background: Gestational weight gain (GWG) impacts both foetal and maternal health outcomes, with excessive GWG in overweight and obese people further increasing the risk of complications for this population. Lifestyle changes including consuming a healthy diet and physical activity are core strategies for management. Since 2020 and the emergence of the COVID-19 pandemic, use of telehealth has increased; however, little is known about the effectiveness of virtually delivered strategies for maintaining healthy gestational weight during pregnancy.

Objectives: To describe the effect of virtually delivered lifestyle interventions on promoting healthy GWG and reducing maternal and foetal complications associated with excessive GWG, with the view to inform future clinical practice.

Design: This systematic review followed preferred reporting items for systematic reviews and meta-analysis (PRISMA) guidelines and targeted quantitative studies assessing virtually delivered lifestyle interventions for maintaining healthy gestational weight for overweight and obese pregnant individuals aged 18 and older.

Data sources and methods: Six databases (MEDLINE, CINHAL, EMBASE, EMCARE, MIDIRS and APA PsycINFO) were searched using a rigorous search strategy. Data extraction investigated mode of telehealth delivery, intervention type and GWG outcomes. Quality appraisal was conducted using the Critical Appraisal Skills Programme tool and risk of bias was assessed using the Risk of Bias assessment (RoB-2).

Results: Nine studies met inclusion criteria and within those studies, six different telehealth modalities were identified. Interventions varied and included GWG tracking, step counts, diet and exercise goal setting. Effectiveness of studies was inconsistent, with five studies demonstrating lower GWG.

Conclusion: Results suggest that lifestyle interventions delivered via telehealth may be effective at reducing excessive GWG. The development of targeted interventions integrated into obstetric guidelines aimed at reducing excessive GWG via telehealth platforms should be considered as a strategy not only for pandemic situations, but to increase antenatal care and service access.

Registration: PROSPERO International Prospective Register on 26 January 2023 (CRD42023392095).

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